# Seizure (Convulsion) - Category: acute - Review status: reviewed (every claim checked against a document named on this page) - Sources: Egyptian National Drug Formulary - nervous-2025.pdf, Diazepam monograph (chapter PDF p21) · Lovik K, Murr NI. Seizure. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. - Verified date: 2026-08 ## Verified against - Egyptian National Drug Formulary - nervous-2025.pdf, Diazepam monograph (chapter PDF p21) - Lovik K, Murr NI. Seizure. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. ## Treatment metadata - Diazepam — injection ## Complete treatment card ```text SEIZURE (CONVULSION) Sources: Egyptian National Drug Formulary - nervous-2025.pdf, Diazepam monograph (chapter PDF p21) · Lovik K, Murr NI. Seizure. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Review status: REVIEWED against 2 sources listed above (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (10) - Sudden loss of awareness with limb movement is how a convulsion is usually described [seizures] - A generalised fit stiffens first and then jerks rhythmically [seizures] - It may begin with a sound or a cry, and some feel a warning or aura first - Wetting is inconstant, so dry clothing rules nothing out [urinary incontinence] - When the tongue is bitten, the bite is usually along its side - Awareness stays altered afterwards, in what is called the postictal state - Brief altered awareness, odd behaviour or a strange perception can equally be a fit [seizures] - The dyscognitive or complex partial kind changes awareness rather than causing a convulsion - It can look like nothing but confusion, with at most lip-smacking or a small movement of a limb [confusion] - In adults the commonest type starts in one area and then spreads fast to the whole cortex SIGNS - what you find (6) - A witness may report open eyes, no response to voice or pain, and rhythmic movements in step - Examine generally and neurologically, hunting for a focal deficit - Red flag: awareness that does not return after a suspected fit raises transformed status epilepticus [seizures · status epilepticus] - Subtle status may show only flickering eyes, facial twitching, limb twitches, or nothing moving - Red flag: status epilepticus is one generalised convulsion past 5 minutes, or a run of them with no full recovery in between [seizures · status epilepticus] - Red flag: the generalised convulsive form of it is an emergency TESTS (12) - Start by asking the carer whether this was a fit at all, or another kind of passing episode - Once it is a fit, decide next whether something provoked it - Ask about earlier fits, medicines, alcohol and illicit drugs, and about low immunity or cancer - Past unresponsive spells may in hindsight have been fits - What happened just beforehand matters, and friends, family or workmates may hold that account - Where epilepsy is already known, ask straight away about missed or erratic doses - Bloods including electrolytes are the usual first tests - Consider lumbar puncture with fever, low immunity, or anything else pointing to brain infection - Brain imaging pays off most when the history or a focal neurological sign points that way - Image after head trauma, cancer, low immunity, fever, lasting headache, anticoagulants, age older than 40 years, or focal onset - After a first fit in an adult back to baseline, check serum glucose and sodium, and pregnancy where relevant - EEG is the marker, and focal or generalised epileptiform discharges are its hallmark IF NOT THIS - what else fits (9) - Fainting is the main rival, and both begin abruptly - A faint tends to have a trigger, a short blackout, and waking without a confused spell - Wetting happens in either, so it does not separate them - A faint can carry jerking that imitates a fit - Psychogenic non-epileptic seizures - Convulsive concussion - A movement disorder, or movements arising out of sleep - Rigors and convulsive syncope belong on the same list as fainting and the psychogenic attacks - Epilepsy means repeated fits with nothing provoking them, so provoked or not is the question that decides both diagnosis and treatment Source StatPearls "Seizure" - disease-level clinical article Status traced to the source above 1. DIAZEPAM [1st line] Adult 5-10 mg IV (preferred) or IM initially by slow injection; may repeat every 10-15 minutes if needed up to a maximum of 30 mg; if necessary repeat again after 2-4 hours, with caution in chronic lung disease or unstable cardiovascular status. - Single acute treatment episode for an ongoing seizure/status epilepticus; not for regular daily use. Peds Paediatric status-epilepticus dosing (including rectal/buccal routes) is specialist-set and is not reproduced here; arrange urgent transfer for any convulsing child. Source Egyptian National Drug Formulary - nervous-2025.pdf, Diazepam monograph (chapter PDF p21) Why Diazepam is the first-line benzodiazepine for terminating an acute seizure or status epilepticus while arrangements are made for urgent transfer/referral. Caution Given by injection, not by mouth: the dose is the IV/IM status-epilepticus line. Diazepam is only for terminating an active seizure or status epilepticus - it is not a maintenance anticonvulsant. There is a risk of respiratory depression, especially given IV or with other sedatives - have resuscitation support available. A seizure lasting several minutes, or repeated seizures without recovery between them, is status epilepticus - a medical emergency needing urgent transfer. Fever with seizure and neck stiffness suggests meningitis/encephalitis - treat and refer urgently. A first seizure in an adult needs urgent work-up for a structural or metabolic cause once terminated. Seizure in pregnancy with high blood pressure suggests eclampsia - manage as an obstetric emergency. Maintenance antiepileptics (levetiracetam, carbamazepine, lamotrigine, valproate) do NOT stop an active seizure and are not on this page. They are under Epilepsy (continuing therapy), which is where a repeat prescription belongs. Egypt VALPAM 5 MG/ML 3 AMP. AMOUN 6.00 EGP EPIVAL 10MG/2ML 3 AMP. EIPICO 15.00 EGP NEURIL 10MG/2ML 5 AMP. MEMPHIS 40.00 EGP Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)